Trochanteric support plate with Dynamic Hip Screw, is this combination a feasible option in unstable trochanteric fractures?
Background: Dynamic Hip Screw (DHS) is the gold standard for stable trochanteric fractures and Proximal Intramedullary nail (IMN) is beneficial in treating intertrochanteric femur fractures with comminution and loss of lateral buttress. DHS augmented with trochanteric support plate can buttress the broken lateral trochanteric wall. Thus we conducted this study is to evaluate the role of the trochanteric support plate (TSP) with DHS in unstable trochanteric fractures.
Materials & Methods: 25 patients presenting with unstable trochanteric fractures treated with TSP with DHS were evaluated for intraoperative blood loss and duration of surgery. Functional outcome was assessed as per the Kyle's Criteria, Harris Hip Score, and ambulatory outcome.
Results: 21 patients with mean age of 67.14 years were available for study. The mean duration of surgery and blood loss was 100.5 minutes and 312 ml, respectively. All fractures, except 1 united. Nonunion occurred in 1 case due to screw cut out. Af final followup, all patients had excellent to good harris hip score and 91% had excellent Kyle’s criteria, while 9% had good Kyle’s criteria.
Conclusion: The DHS with trochanteric support plate is an acceptable alternate device for managing unstable intertrochanteric fractures with broken lateral wall. It’s an easy, low cost, easily available and less demanding surgical procedure giving excellent results.
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